Definition of Dementia -  Dementia is defined as a loss of intellectual abilities such as memory capacity, severe enough to interfere with social or occupational functioning or customary daily living. When this intellectual loss occurs in as a cause of major depression or schizophrenia, it is not called dementia. Customary daily living activities" include balancing the checkbook, keeping house, driving the car, involvement in social activities, and working at one's usual occupation. There may also be changes in personality and emotions. Dementia is not necessarily a normal outcome of aging, but is caused by diseases that affect the brain. Dementia influences all aspects of mind and behavior, including memory, judgment, language, concentration, visual perception, temperament, and social interactions. Although dementia symptoms are eventually obvious to everyone, in the early stages special evaluations are necessary to demonstrate the abnormalities.

Dementia treatment with medication
Natural prevention or treatment for dementia is possible. The treatment of dementia depends largely on the cause. If no serious medical causes are found for dementia, several natural supplements could be helpful, including vitamin B complex and Mind Power Rx. See Memory for more information. At this time modern medicine does not have effective medications for dementia, however natural supplements should certainly be considered. Exercise can reduce the risk for dementia. Older adults who regularly walk for exercise may help lower their risk of vascular dementia, the second-most common form of this disorder after Alzheimer's disease.

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Lifestyle Factors and Dementia
As with heart disease and other illnesses, lifestyle factors are key to preventing the risk of Alzheimer's disease and other forms of dementia. Risk predictors in middle age that could identify people more likely to suffer dementia in later life include low level of education, raised blood pressure, high cholesterol levels, obesity and lack of exercise, which are similar to risk factors for heart disease and strokes.
   Older men and women with chronic emotional distress are more likely to develop dementia. However, distress is not related to the plaques, tangles and other brain changes that mark Alzheimer's disease and other forms of dementia. The implication is that persistent distress may contribute to dementia in some unique, as yet unrecognized way.

Diet and dementia
Those who eat plenty of fruits, vegetables and fish, and have a diet rich in omega-3 fatty acids have a lower risk of developing dementia than those whose diets do not include these healthy food choices.

Green Tea and Dementia help
People who regularly drink green tea may have a lesser risk of dementia as they grow older. A study of more than 1,000 Japanese adults in their 70s and beyond, found that the more Green-Tea men and women drank, the lower their odds of having cognitive impairment. The findings build on evidence from lab experiments showing that certain compounds in green tea may protect brain cells from the damaging processes that mark dementia conditions like Alzheimer's and Parkinson's disease. But while those studies were carried out in animals and test tubes, the new research appears to be the first to find a lower risk of mental decline among green tea drinkers. The possible protective effects of green tea may help explain one reason for Japan's lower rate of dementia, particularly Alzheimer's disease, compared with Europe and North America.

Vitamin C and E supplements do not seem to prevent dementia when used for a few years
Dr. Shelly L. Gray of the University of Washington, Seattle followed 2,969 adults, 65 years of age or older, for an average of 5 years to determine if the use of Vitamin-E or C supplements influenced the risk of dementia or Alzheimer's disease. At the beginning of the study, nearly 33 and 38 percent, respectively, reported using vitamin E and C supplements, and 25 percent of the participants reported taking the vitamin supplements together. The subjects were an average of 75 years old and had no cognitive impairments. Over the course of the study, 405 participants developed dementia and of these, 289 developed Alzheimer's disease. There was no relationship between vitamin supplements and dementia risk.
   Comments: It does not appear that the use of vitamin E and C supplements, when taken for a few years, has a significant influence on the risk of dementia in older individuals. It is not clear whether lifelong use could make a difference. The study was not done in a careful manner. The researchers did not differentiate users in terms of what type of vitamin E supplements were used, whether synthetic, natural, and whether the natural vitamin E included a full spectrum of tocopherols. Journal of the American Geriatrics Society, February 2008.

Hypertension and dementia
Hypertension treatment in old hypertensive subjects may offer some benefit against dementia and cognitive decline. However, there may be risks to hypertension treatment with potent drugs, and caution is advised to use drugs that are safe and do not cause significant side effects.

Drugs for dementia
There are no effective drugs to treat dementia. "There is no drug cure for dementia and many of the medications are being prescribed without evidence. Drugs for dementia currently marketed include cholinesterase inhibitors -- Pfizer and Eisai Co Inc's Aricept; Galantamine, sold generically and under the brand names Razadyne, Reminyl and Nivalin; rivastigmine, sold by Novartis AG under the brand name Exelone; and tacrine, marketed to combat Alzheimer's disease under the brand name Cognex. The fifth drug, memantine, is known as a neuropeptide-modifying agent and is sold by Forest Laboratories under the brand name Namenda. Annals of Internal Medicine, 2008.
   Comments: Since there are no good drugs for dementia, natural supplements should be explored.

Dementia Drugs in UK
Memory clinics and drugs to slow the progress of symptoms of Alzheimer's disease are diverting resources in Britain's state-funded health services from high quality integrated care. Cholinesterase inhibitors have been recommended by the country's cost-effectiveness watchdog, the National Institute for Health and Clinical Excellence (NICE), for patients with mild-to-moderate Alzheimer's disease since 2001. But psychiatrist Anthony Pelosi of the Hairmyres Hospital in East Kilbride, Scotland and his colleagues said memory clinics that were set up to prescribe and monitor the medicines have distorted clinical priorities. The dementia drugs, which cost about 1,000 pounds ($1,907) per patient per year, have turned out to be of marginal benefit from statistical, clinical and public health perspectives. Pfizer Inc and Eisai Co's Aricept; Novartis AG's Exelon; and Reminyl, made by Johnson & Johnson and distributed in Britain by Shire Pharmaceuticals are leading cholinesterase inhibitors.

Exercise offers relief from agitation
In a pilot study, agitation and functioning improved in a group of elderly nursing home residents suffering from severe dementia when they engaged in just 30 minutes of supervised exercise three times a week. Edris Aman, a second-year medical student at Saint Louis University School of Medicine in Missouri, conducted the study. The 50 study participants, whose average age was 79, performed 15 minutes of aerobic exercise and 15 minutes of weight lifting three times a week.
Edris Aman presented his research in April 2009 at the annual meeting of the American Geriatrics Society.

Surgery for Dementia
Some patients who have blocked carotid arteries, the major source of blood flow to the brain, even if there are no symptoms, experience significant improvements in intellectual functioning and reversal of dementia after they undergo surgery to correct this problem. Younger patients and those who have not had a stroke appear to experience the most benefit from the procedure. Carotid stenting involves placement a "stent," a device use to prop open the blocked vessels. Strokes can occur when plaques that have formed in the carotid arteries, which lie on each side of the neck, break off or otherwise obstruct blood flow to the brain.

Prevalence of Dementia
Dementia is reported in as many as 1% of adults 60 years of age and older. It has been estimated that the frequency of dementia doubles every five years after 60 years of age.
   High-complexity jobs that primarily involve work with people or things are associated with a reduced risk of developing dementia.

Dementia symptom and sign
Criteria for the diagnosis of dementia include impairment of attention, orientation, memory, judgment, language, motor and spatial skills, and function.

Type of dementia
Alzheimer's disease is the most common type of dementia
Alcoholic dementia3 - alcohol dementia
Lewy body dementia  - lewey body dementia
Multi infarct dementia
Vascular dementia
Senile dementia

Cause of dementia
In people over the age of 65, the most common cause of dementia is Alzheimer's disease. The causes of dementia include various diseases and infections, strokes, head injuries, drugs, and nutritional deficiencies. Prescription drugs as a cause of dementia are more common that doctors realize.
   Older people who are very thin or are losing weight quickly are at increased risk of developing dementia, especially if they started out overweight or obese.

Cause of Dementia - vasectomy
Men who have had a vasectomy may face an increased risk of developing a rare type of dementia marked by a steady loss of language skills. Researchers at Northwestern University in Illinois, writing in the journal Cognitive and Behavioral Neurology, linked this male sterilization surgery to a neurological condition called primary progressive aphasia, or PPA.

Drugs that cause or accelerate the onset of dementia
Common medicines used to treat depression, Parkinson’s disease and allergies can produce side effects that can lead to cognitive decline and be mistaken for early dementia. These drugs, known as anticholinergics, can cause confusion, memory loss and disorientation. People who use anticholinergic drugs have poorer cognitive performance. Anticholinergic drugs are prescribed to relieve tremors, muscle stiffness, weakness, anxiety, incontinence and sleep problems. The cholinergic system consists of neurotransmitters that regulate a good amount of mental functioning, particularly related to memory.
    Antipsychotic medication to manage dementia related behavioral or psychological symptoms is associated with increased risk of death.

Test for dementia
 It can be difficult for doctors to diagnose dementia because of a lack of availability of objective measures of previous mental ability. Such measures are particularly important in the mild to moderate stages of dementia when the symptoms are not always obvious. An accurate diagnosis allows doctors to rule out other illnesses with similar symptoms, such as depression.
     The following are some tests for dementia: Clinical interview with mental status examination, standard blood work, urinalysis, and standard neurological tests, Mini-Mental State Examination (MMSE),  Clock Drawing Test (CDT), Mini-Cog test, imaging tests such as MRI or X-ray, and EEG (Electroencephalogram).

Dementia raises death risk
Alzheimer's disease and other forms of dementia may have a particularly strong impact on life expectancy among the oldest elderly. A study found that 95-year-olds with dementia were less likely to survive to their 100th birthday than those without dementia. Neurology, November 27, 2007.

Enteral tube feeding
Many patients with severe dementia receive enteral tube feeding, but evidence is lacking that this practice prolongs survival or improves quality of life, according to a report by Dr. Elizabeth L. Sampson. She adds, "some studies suggest that tube feeding may have an effect opposite to the desired and actually increase mortality and morbidity and reduce quality of life." Dr. Elizabeth Sampson and associates at the Royal Free and University College Medical School, London, reviewed seven observational studies comparing groups of patients with dementia who did and did not undergo enteral feeding. None of the studies found a significant association between decreased mortality risk, nutritional parameters, or incidence of pressure ulcers and enteral feeding. Cochrane Database Syst Rev 2009;2.

Dementia Research Update
Supplemental use of antioxidant vitamins and subsequent risk of cognitive decline and dementia.
Dement Geriatr Cogn Disord. 2005;20(1):45-51. Epub 2005 Apr 12.
There are conflicting reports about the potential role of vitamin antioxidants in preventing and/or slowing the progression of various forms of cognitive impairment including Alzheimer's disease (AD). We examined longitudinal data from the Canadian Study of Health and Aging, a population-based, prospective 5-year investigation of the epidemiology of dementia among Canadians aged 65+ years. Our primary objective was to examine the association between supplemental use of antioxidant vitamins and subsequent risk of significant cognitive decline (decrease in 3MS score of 10 points or more) among subjects with no evidence of dementia at baseline (n=894). We also explored the relationship between vitamin supplement use and incident vascular cognitive impairment (VCI; including a diagnosis of vascular dementia, possible AD with vascular components and VCI but not dementia), dementia (all cases) and AD. After adjusting for potential confounding factors assessed at baseline, subjects reporting a combined use of vitamin E and C supplements and/or multivitamin consumption at baseline were significantly less likely to experience significant cognitive decline during a 5-year follow-up period. Subjects reporting any antioxidant vitamin use at baseline also showed a significantly lower risk for incident VCI. A reduced risk for incident dementia or AD was not observed. Our findings suggest a possible protective effect for antioxidant vitamins in relation to cognitive decline but randomized controlled trials are required for confirmation.

Multicentre study of l-alpha-glyceryl-phosphorylcholine vs ST200 among patients with probable senile dementia of Alzheimer's type.
Drugs Aging. 1993 Mar-Apr;3(2):159-64.
The results showed significant improvements in most neuropsychological parameters of dementia in the alpha GPC recipients. Improvements in dementia also occurred in the ST200 recipients but to a lesser extent. Tolerability was good in both groups.

A multicentre trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia.
J Int Med Res. 1991 Jul-Aug;19(4):330-41.
 The results suggest that in most tests alpha-GPC possessed a statistical higher efficacy and an overall more satisfactory activity for dementia treatment assessed by both patients and investigators compared with CDP-choilne.

Natural treatment for dementia questions
Q. My husband was diagnosed with dementia 5 years ago, We went to several doctors and a nutritionist, but we haven't seen any improvement. Would Mind Power Rx help with his memory?
   A. it is difficult to predict the response or dosage of any supplement in any one individual, but, if his doctor approves, he can begin with one Mind Power Rx capsule with breakfast and then his doctor can monitor him.

Q. I am seeking help and information for my wife. She has a diagnosis of Lewy Body dementia. She has had this dementia diagnosis for 2 years and has been going down hill faster now. I have been trying to come up with a supplement package to give what help we can get. She is on Exelon 4.5(patch) Namenda 10mg 2x a day. We are on curcumin 2000 mg Mega-dha 4000 mg, Her medications are mobic 15 mg, and citalopram 10mg, nexium 40 mg, and l-thyroxine 100mg. What suggestion can you give for additional supplements? I know that no Lewy body dementia cure is out there, but seeking all efforts possible to slow down the process. It has been very difficult to find a Dr. who thinks outside of the box.
   A. As of October 2008, I am not familiar with the use of natural supplements specifically for Lewy body dementia, however there is some info on dementia on this page that could be useful. Also, it is difficult to predict the interactions of supplements and medications. Exelon (rivastigmine tartrate) is a reversible cholinesterase inhibitor. Namenda (memantine hydrochloride) is an orally active NMDA receptor antagonist.